Provider Demographics
NPI:1053461624
Name:MOUNTAIN VIEW SURGICAL CENTER INC.
Entity Type:Organization
Organization Name:MOUNTAIN VIEW SURGICAL CENTER INC.
Other - Org Name:SAME AS ABOVE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:K
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-205-9500
Mailing Address - Street 1:16311 VENTURA BLVD
Mailing Address - Street 2:#705
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2124
Mailing Address - Country:US
Mailing Address - Phone:818-205-9500
Mailing Address - Fax:818-990-4453
Practice Address - Street 1:16311 VENTURA BLVD
Practice Address - Street 2:#705
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2124
Practice Address - Country:US
Practice Address - Phone:818-205-9500
Practice Address - Fax:818-990-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical